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Reproductive Health Strategies in India

The document discusses reproductive health in India, highlighting the importance of family planning and the Reproductive and Child Health (RCH) program. It outlines various contraceptive methods, measures taken by the government for awareness, and the implications of medical termination of pregnancy (MTP) and sexually transmitted diseases (STDs). Additionally, it covers infertility and assisted reproductive technologies (ART) available for couples facing challenges in conceiving.

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0% found this document useful (0 votes)
6 views9 pages

Reproductive Health Strategies in India

The document discusses reproductive health in India, highlighting the importance of family planning and the Reproductive and Child Health (RCH) program. It outlines various contraceptive methods, measures taken by the government for awareness, and the implications of medical termination of pregnancy (MTP) and sexually transmitted diseases (STDs). Additionally, it covers infertility and assisted reproductive technologies (ART) available for couples facing challenges in conceiving.

Uploaded by

singhrani2927
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

BIOLOGY

Chapter 4: Reproductive Health


REPRODUCTIVE HEALTH
04

Reproductive Health
Reproductive Health: Problem and Strategies
 India was amongst the first countries in the world to initiate to the programmed
“family planning” initiated in 1951.
 Reproductive health in a society forms a crucial part of general health.
 Improved programs covering wider reproduction-related areas are currently in
operation under the popular name ‘Reproductive and child health care (RCH)
program’.
 Health and education of young people and marriage and child bearing during more
mature stages of life are important attributes to the reproductive health of a society.

Measures taken by Government:


 Through the help of audio-visuals & print media.
 Even family members, close relations are involved in the awareness.
 Sex education was introduced in schools to provide awareness
 Proper information about reproductive organs, adolescence & related changes, safe
&hygienic sexual practices, sexually transmitted diseases, AIDS etc.

Amniocentesis:
It is a technique used to find out chromosomal abnormalities in developing embryo by using
amniotic fluid. It is also misused to check foetal sex determination based on the
chromosomal pattern in the amniotic fluid surrounding the developing embryo.

Population Explosion and Birth Control:


Improved quality of life of people, increased health facilities and better living condition had
an explosive impact on explosion of population. Rapid decline in death rate, MMR (maternal
mortality rate) and IMR (infant mortality rate) along with increase in population of
reproductive age is the main reason for population explosion.

Steps to overcome population explosion:


 Using various contraceptive methods.
 Educating people about the demerits of large family.
 Increasing the marriageable age of female and male
 Providing incentive to parents having 1or 2 children.

GYANWINDOW ACADEMY- Center For Biology - Contact:9479647950 1


REPRODUCTIVE HEALTH
04

Contraceptive methods: Contraceptive methods are used to prevent the unwanted


pregnancy and modifying the menstrual cycle.

An ideal contraceptive should be:

 User friendly
 Easily available
 Effective
 Reversible
 No side effects
 No way interferes with sexual desire and sexual act.

Contraceptive methods could be divided into following categories:

 Natural or traditional methods.


 Barrier methods.
 IUDs.
 Oral contraceptive methods.
 Injectable.
 Implants.
 Surgical methods.

Natural methods:
Natural methods work on the principle of avoiding chances of ovum and sperm meeting.

It includes:

Periodic abstinence: The couples avoid coitus from day 10 to 17 of menstrual cycle as
chances of fertilization are very high during this period, it is called the fertile period.

Withdrawal or coitus interruptus: Male partner withdraws penis from vagina just before
ejaculation to avoid insemination.

Lactational Amenorrhea: Absence of menstruation after parturition and due to intense


milk feeding and no ovulation in this period, chances of fertilization is nil.

In Barrier methods:
In Barrier methods, ovum and sperms are prevented from physical meeting with help of
barrier.

GYANWINDOW ACADEMY- Center For Biology - Contact:9479647950 2


REPRODUCTIVE HEALTH
04

This includes:
Condoms for male: Used by male, barrier made of rubber or latex sheet used to cover penis
or vagina and cervix of female. It also prevents from STDs.

Condom for female: Diaphragms, cervical cap and vaults are barrier made of rubber that is
inserted into the female reproductive tract during coitus. Spermicidal creams, jellies and
foams are usually used along with these barriers to increase their contraceptive efficiency.

Advantages of barrier methods:

 They are disposable.


 They can be self-inserted.
 They are reusable.
 Prevents conception by blocking entry of sperm through cervix.

Intra uterine Devices:Inserted by doctor or trained nurse into the female uterus through
vagina. IUCDs may be non-medicated IUDs (e.g., Lippes loop), copper releasing IUDs
(CuT, Cu7, Multiload 375) and the hormone releasing IUDs (Progestasert, LNG-20). IUCDs
increase the phagocytosis of sperm in uterus and copper reduce the motility and fertility
capacity of spermsThe hormone releasing IUDs make the uterus unsuitable for implantation
and the cervix hostile to the sperms. It is ideal for female who wants to delay pregnancy and
spacing between two children.

GYANWINDOW ACADEMY- Center For Biology - Contact:9479647950 3


REPRODUCTIVE HEALTH
04

Oral Pills: Oral Pills are progesterone or progesterone-estrogen combination used by


females in form of tablets. They inhibit ovulation and implantation as well as change the
quality of cervical mucus to prevent/ retard entry of sperms. Administration of progesterone
or progesterone-estrogen combination within 72 hours of coitus is found to be very effective
as emergency contraceptive.

Surgical method: This method is also called sterilization. It is used as terminal method of
contraception in male and female to prevent any more pregnancy.

Vasectomy: Vasectomy is the surgical method in male; a small part of the vas deferens is
removed or tied up through a small incision on the scrotum to prevent release of sperms.

Tubectomy: Tubectomy is the surgical method in females in which small part of fallopian
tube is removed surgically.

GYANWINDOW ACADEMY- Center For Biology - Contact:9479647950 4


REPRODUCTIVE HEALTH
04

These techniques are highly effective, but their reversibility is very poor.

Side effects of contraceptive method:

It is very important that the selection of contraceptive method should be taken under the
consultation of the doctors.
They have ill-effects like nausea, abdominal pain, breakthrough bleeding, irregular
menstrual bleeding or even breast cancer.

Medical Termination of Pregnancy (MTP):


 Voluntary termination of pregnancy before full term is called MTP (medical
termination of pregnancy) or induced abortion. It plays important role in decreasing
population by aborting unwanted pregnancy.
 In India, MTP is legalized in 1971 with some restriction to prevent its misuse such as
indiscriminate and illegal female foeticides.
 MTP is used to Get rides of unwanted pregnancy due to unprotected intercourse or
failure of contraceptives used during coitus or rapes.
 When pregnancy continuation could be harmful or even fatal to mother or foetus.
 MTPs are considered relatively safe during first trimester or up to 12 weeks of
pregnancy. Second trimester MTPs are much riskier.

Sexually Transmitted Disease (STDs):


Diseases or infections which are transmitted through sexual intercourse are collectively
called sexually transmitted disease or venereal disease (VD) or reproductive tract infection
(RTI).
Some common STDs are Gonorrhea, syphilis, genital herpes, chlamydiasis, genital warts,
trichomoniasis, hepatitis-Ba and AIDS.
Hepatitis-B and HIV is also transmitted by sharing of injection needles, surgical instruments
with infected person, transfusion of blood, or from infected mother to foetus.
Except genital herpes, HIV and hepatitis-B are completely curable if detected earlier and
treated properly.
Timely detection and proper treatment of STDs are very important otherwise it could lead to
complications later, which include pelvic inflammatory diseases (PID), abortions, still births,
ectopic pregnancies, infertility or even cancer of the reproductive tract.

GYANWINDOW ACADEMY- Center For Biology - Contact:9479647950 5


REPRODUCTIVE HEALTH
04

Infections of STDs can be prevented by:


 Avoid sex with unknown partners/ multiple partners.
 Always use condoms during coitus.
 Go to a qualified doctor in case of doubt for early detection and get complete
treatment if diagnosed.

Infertility:
The couples which are unable to reproduce children in spite of unprotected sexual
cohabitation are called infertile. The reasons for this could be many-physical, congenital,
diseases, drugs, Immunological or even Psychological.

Assisted reproductive technologies (ART):


Infertile couples can be assisted to have children through certain special techniques
commonly called assisted reproductive technologies (ART),

Which includes:
In vitro fertilization (IVF): In vitro fertilization (IVF) fertilization outside the body
followed by embryo transfer, which is commonly called test tube baby program. The ovum
from wife/ donor and sperms from husband/ donor are collected and induced to fertilize in
laboratory conditions.

ZIFT (zygote infra fallopian transfer): The zygote or early embryo (8 blastomeres) could
be transferred into fallopian tube called ZIFT (zygote infra fallopian transfer) and embryo
with more than 8 blastomeres.

IUT (intra uterine transfer): IUT (intra uterine transfer) into the uterus to complete the
further development. Embryos formed by in-vivo fertilization (fusion of gametes within the
female) also could be used for such transfer to assist those females who cannot conceive.

GIFT (gamete intra fallopian transfer): Transfer of gametes collected from a donor into
fallopian tube of another female who do not produce ovum.

Intra cytoplasmic sperm injection (ICSI): Specialized procedure to form an embryo in


laboratory in which sperm is directly injected into ovum.

Artificial insemination: Infertility cases in which male partner is unable to produce healthy
sperms are treated by this technique in which semen collected from donor is artificially
introduced into vagina or into uterus, IUI (intra uterine insemination) of the female.

GYANWINDOW ACADEMY- Center For Biology - Contact:9479647950 6


REPRODUCTIVE HEALTH
04

All these techniques require extremely high precision handling by specialized professional
and expensive instruments. Therefore, their benefits are limited to certain countries and
people. Emotional, religious, and social factors also prevent the adoption of these methods.

GYANWINDOW ACADEMY- Center For Biology - Contact:9479647950 7


REPRODUCTIVE HEALTH
04

GYANWINDOW ACADEMY- Center For Biology - Contact:9479647950 8

Common questions

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Socio-cultural factors significantly influence the acceptance of reproductive health programs like ARTs in India. Factors such as traditional beliefs, societal norms regarding family size, and perceived stigma around infertility or ART contribute to varying levels of acceptance . Success is contingent on considering these factors and integrating culturally sensitive approaches into program implementation to ensure broader acceptance and effectiveness .

The use of advanced contraceptive techniques such as IUDs and hormone-based contraceptives raises ethical dilemmas related to potential side effects and informed consent. There are concerns about ensuring individuals have comprehensive understanding before use, and balancing access with safety . There are also debates over accessibility and affordability, especially in less economically developed regions .

India's strategies for managing population explosion include promoting contraceptive use, educating about the disadvantages of large families, increasing marriageable age, and providing incentives for smaller families . These strategies are potentially effective as they address both the supply of education and resources and demand through incentives. However, socioeconomic and cultural challenges could affect their implementation and acceptance across diverse communities .

Amniocentesis medically serves to detect chromosomal abnormalities in embryos, but it is misused for determining fetal sex, leading to sex-selective abortions . Ethically, this misuse highlights issues of gender bias and discrimination, raising concerns about the societal implications of enabling sex-selective practices, which can lead to skewed gender ratios and reinforce gender inequality .

Barrier contraceptive methods, such as condoms, provide dual benefits by preventing both conception and the transmission of sexually transmitted diseases (STDs). They are disposable, easy to use, and can be self-inserted, which contributes significantly to public health by reducing the incidence of STDs and unwanted pregnancies when used correctly . Their accessibility and ease of use empower individuals to take more control over their reproductive health .

ART, including IVF, ZIFT, IUT, GIFT, ICSI, and artificial insemination, play essential roles in assisting infertile couples to conceive . However, these technologies face limitations such as high costs, limited availability in certain areas, and cultural or religious resistance, which restrict their accessibility to many potential users. Additionally, they require highly skilled professionals and sophisticated equipment, further limiting their implementation .

While MTP plays a crucial role in reducing unwanted pregnancies and is relatively safe within the first trimester, its misuse for sex-selective abortions is a significant issue . The ethical considerations include the potential for gender discrimination and the violation of legal restrictions aimed at preventing female foeticide. These practices can exacerbate gender imbalances and reinforce societal biases against women .

The RCH program was developed to focus on improving reproductive health as a crucial part of general health. The initiative aimed to address issues such as high population growth due to factors like improved health facilities, the decline in death rates, and an increase in the number of people in the reproductive age group .

Preventing STDs involves challenges such as lack of awareness, social stigma, and risky sexual behaviors. Effective measures include promoting the use of condoms, encouraging regular medical check-ups, and providing comprehensive sex education to improve awareness and early detection . Public health campaigns and access to healthcare services are crucial in reducing transmission rates and complications associated with STDs .

Contraceptive methods have evolved to become more user-friendly, accessible, effective, reversible, and with fewer side effects, aligning with the criteria of an ideal contraceptive . Natural methods, barrier methods, IUDs, oral pills, injectable methods, implants, and surgical methods offer varied options. However, challenges such as ensuring proper education, access in different socioeconomic settings, and managing side effects still remain .

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